In developing countries, where 80% to 85% of childhood cancer cases occur, the survival rate is often less than 10%. The mission of the International Outreach Program (IOP) at St. Jude Children's Research Hospital is to improve the survival rate of children with cancer. Essential to this mission is the provision of quality nursing care. In May 2006, the quality of nursing care at an IOP Central American partner-site was assessed using nursing standards endorsed by the Joint Commission International (JCI). The assessment provided objective and credible findings and a baseline from which nursing needs and recommendations were determined. After careful review of data, the IOP staff provided recommendations in the areas of education, staffing, compensation, and communication.